What is the BP cutoff value for the diagnosis of hypertension?

LETTERS TO THE EDITOR

What is the BP cutoff value for the diagnosis of hypertension?

Dear Editor,

I would like to congratulate Costa et al¹ for their published study on the prevalence of systemic arterial hypertension (SAH) in the city of Pelotas, Rio Grande do Sul, Brazil. We observed that blood pressure levels > 160/95 mmHg were considered diagnostic for hypertension. However, even considering the limitations that are inherent to the measurement of blood pressure levels performed at a single occasion for the diagnosis of hypertension, I believe the study would have better portrayed what is taking place concerning the prevalence of the disease if the cutoff had been 140/90 mmHg, which is the one recommended by several national and international guidelines^2-5. Therefore, it would be interesting to perform a re-analysis of the presented data using the cutoff that is adopted worldwide. The threshold used in this study tends to reduce the disease detection sensitivity and, consequently, might have underestimated the SAH prevalence found in this sample.

José Fernando Vilela Martin

Faculdade de Medicina de São José do Rio Preto

São José do Rio Preto

[e-mail]

1. Costa JSD, Barcellos FC, Sclowitz ML, Sclowitz IKT, Castanheira M, Olinto MTA, et al. Prevalência de Hipertensão Arterial em Adultos e Fatores Associados: um Estudo de Base Populacional Urbana em Pelotas, Rio Grande do Sul, Brasil. Arq Bras Cardiol. 2007; 88(1): 59-65.

2. Mion Jr D, Machado CA, Gomes MAM , Nobre F, Kohlmann Jr O, Amodeo C et al. IV Diretrizes Brasileiras de Hipertensão Arterial. Arq Bras Cardiol. 2004; 82 (Suppl 4): S7-22.

3. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003; 42 (6): 1206-1252.

4. Cifkova R, Erdine S, Fagard R, Farsang C, Heagerty AM, Kiowski W, et al. ESH/ESC Hypertension Guidelines Committee. Practice guidelines for primary care physicians: 2003 ESH/ESC hypertension guidelines. J Hypertens. 2003; 21(10):1779-86.

5. V Diretrizes Brasileiras de Hipertensão Arterial (on line) (citado 2007 janeiro 21). Disponível em: http://departamentos.cardiol.br/dha/consensos.asp

THE AUTOR REPLY

Dear Editor,

Important epidemiological studies have contributed to the understanding of arterial hypertension in the state of Rio Grande do Sul, Brazil^1,2,3,4,5,6. All the studies performed have chosen the cutoff used in our study (>160x95 mm Hg), utilizing a higher specificity parameter. Other, more current studies also chose the 140 x 90 mmHg cutoff ^3,4. However, the main reason for maintaining the cutoff was the possibility to compare results with another important study, which was previously carried out in Pelotas with a population within the same age range⁵, thus allowing the comparison among independent variables and of the same outcome throughout time.

Juvenal Soares Dias da Costa

Universidade do Vale do Rio dos Sinos

São Leopoldo, RS

Universidade Federal de Pelotas

Pelotas, RS

[e-mail]

1. Achutti A, Medeiros AMB, Azambuja MIR, Costa EA, Klein CH. Hipertensão arterial no Rio Grande do Sul. Boletim de Saúde 1985; 12(1):6-54.

2. Duncan BD, Schmidt MI, Polanczyk CA, Homrich CS, Rosa RS, Achutti AC. Fatores de risco para doenças não-transmissíveis em área metropolitana na região sul do Brasil. Prevalência e simultaneidade. Rev Saúde Pública. 1993; 27(1):143-8.

3. Fuchs FD, Moreira LB, Moraes RS, Bredeneir M, Cardozo SC. Prevalência de Hipertensão Arterial Sistêmica e Fatores Associados na Região Urbana de Porto Alegre. Estudo de Base Populacional. Arq Bras Cardiol. 1995; 63(6):473-79.

4. Gus I, Harzheim E, Zaslavsky C, Medina C, Gus M. Prevalência, Reconhecimento e Controle da Hipertensão Arterial Sistêmica no Estado do Rio Grande do Sul. Arq Bras Cardiol. 2004; 83(5):424-428.

5. Piccini RX, Victora CG. Hipertensão arterial sistêmica no sul do Brasil: prevalência e fatores de risco. Rev Saúde Pública. 1994; 28:261-7.

6. Trindade IS, Heineck G, Machado JR, Ayzemberg H, Formighieri M, Crestani M, Gusso J. Prevalência de Hipertensão Arterial Sistêmica na População Urbana de Passo Fundo (RS). Arq Bras Cardiol. 1998; 71(2):127-30.

Publication Dates

• Publication in this collection
  15 June 2007
• Date of issue
  May 2007